Avoiding Burnout

It’s that time of year! This April, I will once again be participating in the A to Z Blogging Challenge. Every day (except Sundays) bloggers post to their blogs something that pertains to a specific theme (usually) and corresponds to the letter of the alphabet assigned to that day. Today is the day when participants reveal their chosen theme. Last year my theme was “Caregiving.” This year I’m going to branch off from that theme and focus on something that caregivers (and everyone else) from time to time, must battle. Facing Cancer with Grace’s theme in 2019 is…

Avoiding Burnout

Burnout is the result of prolonged, excess stress. It can leave you mentally overwhelmed, physically exhausted, emotionally drained, and even spiritually withdrawn.  Burnout renders you unable to keep up with demands of caregiving and even mundane, everyday tasks.

Some Signs of Burnout:

  • Chronic fatigue
  • Frequent illness (low immunity)
  • Headaches
  • Weight fluctuations (Increased/decreased appetite)
  • Anxiety/Depression
  • Lack of motivation
  • Forgetfulness
  • Trouble Concentrating
  • Hopelessness
  • Increased irritability/anger
  • Self-isolation
  • Becoming cynical
  • Sleep disturbances
  • Loss of Joy

A to Z in 2 Places!

Once again I will be doing the A to Z Blogging Challenge on both of my blogs. I will be sharing ways to avoid burnout, here at Facing Cancer with Grace.  At Heather Erickson Author/Writer/Speaker, I will share ways of thinking creatively, using Brainsparker’s Kickstart Course of A to Z prompts. I hope you’ll visit me at both places.

To give you a preview of some of the posts I have (and will have) written, I am posting the schedule. These links will go live when the post is up at 7 AM CST on the following dates:

April                       Topic

1              A             Asking for Help

2              B             Begin your day right

3              C             Clear the Clutter

4              D             Date Night

5              E              Eliminate one Obligation

6              F              Financial Help

8              G             Give up the Caregiver Guilt

9              H             Hug Someone You Love

10           I               Imagine You’re on a Beach: Visualization

11           J              Journal to Avoid Burnout

12           K             Keep Yourself Accountable by Seeing a Therapist

13           L              Lift Someone’s Spirits by Listening

15           M            Mindfulness to Avoid Burnout

16           N             Say No to Avoid Burnout

17           O             One Thing a Day to Avoid Burnout

18           P             Having Pets for Stress Relief

19           Q             Quit a bad habit

20           R             Respite Care for Burnout Prevention

22           S              Sleep Hygiene

23           T              Thankful for the Gift of Gratitude

24           U             Unload 3 Things: Should’ve, Could’ve, Would’ve

25           V             Vacation to Avoid Burnout

26           W            Walking to Keep Burnout at Bay

27           X             X (10) Ways to Cope with Stress

29           Y              Your Self Care Plan to Avoid Burnout

30           Z              Zip through Your Household Chores

May 6                     A to Z Reflections

What Are Your Thoughts?

Please share in the comment section, below. I appreciate my readers as well as the writing community. To show that appreciation, I use Comment Luv. Just leave a comment below and your latest post will get a link next to it. Thank you!

ABOUT HEATHER ERICKSONThe Erickson Family

In 2012 doctors diagnosed my husband, Dan, with stage IV lung cancer. Since then, our family has been learning what it means to face cancer. I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, in spite of their illness. My goal is to help people face cancer with grace. My books are available at Amazon.com:

The Memory Maker’s Journal 

Facing Cancer as a Friend: How to Support Someone Who Has Cancer

Facing Cancer as a Parent: Helping Your Children Cope with Your Cancer

I also blog at Heather Erickson Author/Writer/Speaker

 


Holiday Stress

Holidays like Christmas usually mean getting together with family. It’s part of what makes the holidays special. But, it can also be stressful. Sometimes family relationships are strained, adding anxiety to the mix. What makes this worse? How can you cope with stress within your family, especially during the holidays? Part of it will depend on personality.

What’s your personality type?

Are you typically:

  • Laid back, able to roll with whatever comes at you?
  • Uncomfortable with changes in your life, even positive changes?
  • Quick to see what could go wrong, and able to find solutions to those problems?
  • Always able to keep a positive outlook, even if that sometimes means avoiding the possibility that something could go wrong?
  • Prone to depression or anxiety, unable to cope with stress?
  • Quick with a joke to lighten even the bleakest mood—even if it’s sometimes inappropriate?

A Chemistry Lesson

Family members are really like individual chemicals. Because a family is comprised of multiple people, each with their own personality and coping mechanism. When different members of a family interact the result is the emotional equivalent to a chemical reaction.

Think about what happens when one person in the family is gone for a couple of days. Have you ever noticed how suddenly the hierarchy in your home changes? Even the volume in the house will change. When our daughter, Summer, began college, she was suddenly gone for over 12 hours a day. The house was suddenly much quieter. On the other hand, when my husband goes camping for a couple of days, our daughters and I get really loud.

Sometimes, like acid and alkaline, people will balance one another out, keeping the family stable. Other times, rather than balancing one another out, the way individuals cope with stress can combine like vinegar and baking soda, and the unstable combination[1] bubbles over.

Stress in families depends on your chemistry

How to Cope with Stress under Pressure

When a stressful situation arises, such as a cancer diagnosis, an individual’s tendencies become amplified. So will a family’s interactive response. Each family is different. The way the Smith family deals with a crisis won’t be the same way the Johnson family does. Yet, these unique systems usually enable the family that’s implementing them to cope with stress in their own way. It’s important to keep your family’s way of coping in mind.

Pray for your Family

The best prevention and weapon against stress is to take it to the Lord in prayer. Set aside time each day to pray, not only for the situation but for the members of your family. Often we want to change the way someone else does or sees things. I’ve found that it’s more helpful to ask God to open my eyes to see others’ perspectives.

Think about how this works within your family. How does each of you cope with ordinary stress? In what ways is this amplified when something major comes up? Can you be more gentle with one another and support each other in healthier ways? Let the answers to these questions help you to have a more, Merry Christmas and get through the crises of life better.

[1] Vinegar, which contains acetic acid. When you add it to baking soda (sodium bicarbonate), carbonic acid is produced. Carbonic acid is very unstable and immediately breaks down into carbon dioxide and water. This carbon dioxide gas escapes causing the “fizz” you see erupting from science fair volcanoes everywhere. If you’ve never done this experiment, try it!

What are YOUR thoughts?

I’d love to hear in the comment section, below. I appreciate my readers as well as the writing community. To show that appreciation, I use Comment Luv. Just leave a comment below and your latest post will get a link next to it. Thank you!

ABOUT HEATHER ERICKSON

In 2012 doctors diagnosed my husband, Dan, with stage IV lung cancer. Since then, our family has been learning what it means to face cancer. I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, in spite of their illness. My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com

I also blog at Heather Erickson Author/Writer/Speaker

The Erickson Family, Photo by Everbranch Photography

Originally posted 2017-12-14 01:01:16.


Understand Death

I’m doing double duty this month during the A to Z Blogging Challenge. Here at Facing Cancer with Grace, I will focus on caregiving. I’ll also be doing the challenge at Heather Erickson Author/Writer/Speaker, where I will share ways to increase your creativity. I hope you’ll visit me at both sites. While you’re here, sign up for my email list. Today’s post is K for How Kids Understand Death. This post is an excerpt from my upcoming book, Facing Cancer as a Parent: Helping your Child Cope with Your Cancer.

In a recent post, we looked at Grief in Children from the viewpoint that grieving begins with a loss. It’s important to understand death isn’t the only thing reason we grieve. Unfortunately, for many families, the cancer journey does end in death. What you see in your child as they cope with death will depend largely on their age and how they understand death.

Infants, up to 2 years old

Infants won’t understand death at all, but that doesn’t mean that they aren’t affected by it. They know that the parent they loved is no longer there. You may even see an older infant looking for their “missing” parent. Even more than the absence of their parent, infants are affected by the sadness of their surviving parent.

What you can expect to see from your child as they cope with death as an infant up to 2 years old:

  • increased crying
  • irritability
  • changes in sleeping habits.
  • changes in eating habits

Preschool-age children (3 to 6 years)

Children ages 3-6 are curious about death, but they don’t understand death as a permanent condition. It’s common for them to think that someone who’s died is in a state similar to sleep. They may believe it’s reversible and that their parent will wake up. They might even think that if they’re good enough, they can make the person who died come back.

Children tend to center the death (like everything else) on themselves. If they have ever wished their parent would go away or had been “bad,” they may feel guilty and responsible for their parent’s death. It’s very difficult for children this age to put their feelings into words.

As you would expect, children who lose a parent are apt to worry about who will take care of them. They may question whether their other family members are safe, or if one day, they too will die, leaving the child behind. And, like children younger than them, they’re very affected by the sadness of surviving family members.

What you can expect to see from your child as they cope with death as a preschooler:

  • symptoms of regression
  • bed-wetting
  • thumb-sucking
  • acting out in aggression
  • irritability
  • difficulty sleeping

Our Story

I met, fell in love with, and married Dan when my daughters were young. before that, I was married to my children’s biological father. He left us, After that, for weeks, one of my daughters kept saying he had been shot. No matter what I said to try to convince her otherwise, she thought he had died. I took them to our pastor who began to talk to them and asked them questions. He asked her why she thought that he was dead. She said, “It’s like in Narnia. The dad went to war and was shot. The children were sad and the mom cried all the time.” My daughters didn’t understand what divorce was but they had seen in a movie, something that resonated with how they were feeling. They drew their own conclusions from that. This taught me a big lesson about children’s perceptions. This taught me a big lesson about children’s perceptions.

Be aware that your young child may not understand death accurately. Asking gentle questions can be very illuminating.

School-age children (6 to 12 years)

By the time your child reaches the ages of 6-12, they understand death is final. As they get older, they’ll understand death is unavoidable and happens to everyone at some point. Death itself is often perceived by children this age, symbolically, such as a skeleton, the Grim Reaper, or a more religious manifestation, such as an angel or spirit. Children this age will still struggle to talk about their feelings.

They will experience many emotions including guilt and shame, since they may worry that they’re to blame for their loved one’s death. They may also feel anger and sadness. And, most likely, they’ll experience anxiety and fear about their future and even their own death. They’re still likely to worry about who will take care of them. This can bring about feelings of insecurity, clingy behavior.

Children this age are often interested in the specific details of death and what happens to the body after death. This can even be seen when a pet dies. Far from being gruesome, the child may want to see the dead pet and know more clearly what has happened. While adults may feel uncomfortable with this, it’s quite natural, and a part of coming to terms with the death. For this reason, you shouldn’t be overly concerned if the child wants to see or touch their deceased parent.

What you can expect to see from your child as they cope with death as a school-aged child, 6-12 years old:

  • symptoms that their younger counterparts experience
  • trouble in school
  • withdrawal from friends and/or family

Our Story

When our kids were younger, they had a pet betta fish. After about 6 months, Huckleberry did what all fish eventually do, and died. I was concerned that it would upset the kids, so I tossed the fish into the brush outside of our home.

Our daughter became frantic at seeing the empty fish bowl. She cried and cried, demanding to see her little Huckleberry. Finally, I relented and told her where he was. She rushed out in her bare feet, searching through the leaves and branches. Finally, she found him. She looked at him for a few minutes in silence and then returned as calm as could be. She wiped her eyes and returned to playing.

Teenagers (13 to 18 years)

While most teenagers understand death in like adults do, when it comes to death, they don’t behave like an adult. They’ll experience a range of emotions, and don’t have the depth of experience or the coping skills needed to handle them. Teens don’t tend to ask for help. Instead, you’ll need to recognize that they’re struggling.

Signs to watch for in your child as they cope with death as a teenager, include:

  • Lashing out at family members or friends.
  • Reckless and/or impulsive behavior
  • Substance use/abuse
  • Promiscuity.
  • Questioning God, their faith, and/or their understanding of the world
  • Withdrawing from the family to be alone
  • Spending more time with friends (not always a bad thing, but can be an indicator that they are having difficulty dealing with what’s happening)

Because they want to feel independent, teens sometimes want to emotionally and physically separate from their family. They may not be receptive to support from adult family members. It can be helpful to enlist the help of other adults who can help identify when a problem is occurring. Communicate regularly with their teachers, coaches, and pastors who can help during this time.

College Age

Despite being considered legal adults, college-aged children are still developing emotionally. Their brain isn’t fully formed until they are 25 years old. To make matters even more complicated, these are the years when many of them are in college or starting their career. Whether they live on campus, commute, or have decided to work full time, they have a lot that they are juggling.

Thankfully, many colleges have academic and crisis counselors on staff. Students should contact them early on to see what options they have regarding their classes, should a crisis such as the death of a parent, arise. Some schools even offer tuition insurance for a medical crisis. Check with the school to find out details, including any potential issues with their scholarships. Make sure any insurance you purchase will cover the any needed time off from school for your child as they cope with death.

Our daughter, Summer

Summer and Dan August 2016
Photo by Jim Bovin

Our oldest daughter, Summer had already completed 2 years of college by the time she was 18 through a

program the State of Minnesota has known as Post Secondary Options (PSEO). She then transferred to the University of St. Thomas where she would get her 4-year degree.

We knew that during her time there, it was likely her dad would die. How would she cope with that? It’s one thing to deal with the pressures of college when you have a sick parent. It’s a whole other matter to try to focus on an intensive time of studies when your parent dies.

Summer spoke with her academic counselor as well as the student counselor who deals with issues such as grief. She began to assemble her support system at school.

School can be a welcome escape for your child as they cope with death. Or, it can add to the overwhelming feelings they may be experiencing. How your child deals with the loss of a parent will be as individual as he or she is.

Helping your child cope with and understand death

It’s common for surviving parents, family members and friends to worry about how their grief will affect the kids. They worry that their children will be damaged by their own intense feelings about the loss. Because of this, some adults will try to hide their emotions while around children. This is unnecessary and can be harmful in the long run—for everyone.

Children look for cues from adults for how to react to what’s happening around them. There’s nothing wrong with crying or other expressions of intense feelings after a loved one’s death. These are normal expressions of how people feel when they lose someone important to them.

The way you, and others, react to your child as they cope with death through the mourning process, will send a message to them, whether you intend to or not. For example. Telling a child not to cry, can cause them to feel like their feelings are wrong. This denies them the opportunity to work through the variety of emotions they are feeling, related to the loss.

Don’t try to hide your feelings

If family members and friends try too hard to hide their feelings, the child may think it’s wrong to be open about their own feelings. Instead of being able to share their feelings and get the needed support, the child keeps it inside and doubts the validity of their feelings.

Genuine feelings of sadness, tears, and anger are normal reactions for anyone who’s grieving. While acting hysterical may frighten a child, as long as their security needs are being met, seeing your grief being expressed won’t damage them.

In the same way, telling them that they should be more upset can cause him or her to feel guilty. It implies they are a bad person for not responding to the loss “appropriately.” Sometimes, outward displays of grief are delayed, or even suppressed due to mixed signals they’ve gotten in the past about whether or not it’s okay to cry. It’s important that your children understand death is a painful loss and it’s okay to respond to it in a way that feels authentic.

Resources

I’m in the early stages of putting together a resource page for caregivers of cancer patients. I’d love it if you’d check it out and email me any suggestions of resources you’d recommend. While you’re here, sign up for my email list to get a periodic email newsletter to encourage you on your cancer journey.

WHAT ARE YOUR THOUGHTS?

I’d love to hear in the comment section, below. I appreciate my readers as well as the writing community. To show that appreciation, I use Comment Luv. Just leave a comment below and your latest post will get a link next to it. Thank you!

ABOUT HEATHER ERICKSON

In 2012 doctors diagnosed my husband, Dan, with stage IV lung cancer. Since then, our family has been learning what it means to face cancer. I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, in spite of their illness. My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com

I also blog at Heather Erickson Author/Writer/Speaker

 

Originally posted 2018-04-12 07:00:34.


Breathing Technique

This is part 3 of our Breathless Series. In Part 1, we looked at some of the reasons for breathlessness in cancer patients. I also shared my husband’s experience with shortness of breath to the point he nearly died. In Part 2, we looked at medical approaches to breathlessness. This post will be about non-medical approaches to breathlessness, including breathing technique and ways of controlling your environment to alleviate symptoms of breathlessness.

Non-medical approaches, including specific breathing technique, can be very effective ways to breathe easier.

On January 25, 2017, the Lung Cancer Alliance, kicked off their Coping Series with a webinar called “Breathing Easier.” The Coping Series is designed to educate and provide practical ways to manage the most common symptoms and side effects experienced by lung cancer patients and survivors. If you would like to see the full webinar, click here.

I would like to thank the Lung Cancer Alliance and the webinar presenters. They’ve kindly allowed me to share (originally on Heather Erickson Author/Writer/Speaker) the information they taught, along with some slides from the webinar. I especially thank Dr. Lynn Reinke, a nurse practitioner, recognized nationally and internationally as a dyspnea crisis management expert (1). She spoke about breathing technique and other non-medical interventions to improve breathing.

Breathing Technique: Pursed-Lip Breathing

There are many advantages to the pursed lip breathing technique. It is simple to do. In fact, many people intuitively use this method of breathing when they are breathless. It can be used when you are at rest, as well as when you are active. This breathing technique is perfect for when you are climbing stair since it increases your blood oxygen levels.

Here’s how you do it:

  1. Relax
  2. With your mouth closed, inhale through your nose. Count 2-4 seconds as you breathe in.
  3. Now, purse your lips (as if you’re going to drink from a straw).
  4. Exhale slowly through your pursed lips. Count 6-8 seconds as you breathe out.
  5. Repeat as often as you need.
Breathing Technique
Courtesy of the Lung Cancer Alliance

Breathing Technique: Diaphragmatic Breathing

Most people breathe wrong. When they take in a breath, their stomach contracts as they fill their lungs. That’s not the way we were created to breathe. The next time you get to see a baby lying on its back, watch him or her breathe. What do you notice? Their tummy rises as they inhale and sinks as they exhale. That’s because their diaphragm is doing its job the way it was meant to. Check out the diagram below to see what I mean.

By using the diagrammatic breathing technique, you will strengthen your diaphragm and reduce breathlessness, long term.

Bonus: This not only helps with breathing but also with pain control. Because of chronic pain, I go to a pain clinic. In physical therapy, this was the first thing they taught me. Pain perception and pain threshold are both affected by relaxation and the use of the diaphragmatic breathing technique.

Breathing Technique
Courtesy of The Lung Cancer Alliance
Breathing Technique
By John Pierce (Own work) , via Wikimedia Commons

Positioning: Leaning Over

Leaning over helps you to relax your shoulders and upper chest so that your diaphragm can expand opening up your lungs. There are several ways you can do this.

  • Leaning over a grocery cart while shopping
  • Lean over the back of a stable chair.
  • Rest your head on a pillow while seated at a table.

Don’t bend over too far, or you will make it harder for your diaphragm to do its job.

Breathing Technique
Courtesy of The Lung Cancer Alliance

Tricking Your Brain:

One interesting intervention involves using a hand-held battery-operated fan.

  • Aim the fan at your nose/face.
  • Hold the fan 6 inches away.
  • Continue to have the fan blowing on your face for 5 minutes.

It’s believed that the effect of the air stimulates your facial nerves, changes the perception of breathlessness in their brain.

Here is a highly recommended fan on Amazon:
VersionTech Multipurpose Collapsible Portable Fan Outdoor Fan Clip Fan Desktop Fan(3 Speed, Black)

Relaxation technique: Progressive Muscle Relaxation

This can be used in conjunction with the diaphragmatic breathing technique.

Progressive muscle relaxation is just that—you progress through your body, relaxing your muscles one at a time until you are completely relaxed. This reduces anxiety, helping you to breathe better. This has the same pain relieving bonus as the diaphragmatic breathing technique.

Often this is done by listening to a recording which prompts you to imagine… After you’ve done this a few times, you will be familiar with it and will be able to do it at any time you need to even if you don’t have a recording to listen to.

Here are the basics of PMR:

  • Either lie down or sit in a comfortable chair and relax.
  • Take a few deep breaths by using the diaphragmatic breathing technique.
  • Focus on your toes. Scrunch them up, and then release.
  • Next, tense your ankles and release.
  • As you move through the body, you will repeat this. After releasing, you will keep that part of the body relaxed as you progress through the rest of your muscles. Take a deep breath between each muscle group.
  • Tighten and then release your calf muscles, thigh muscles, your buttocks, and pelvic area.
  • Now, breathe deeply in, and as you breathe out, slowly relax and release any tension you may have in your back.
  • Lift your shoulders and then release completely.
  • Now relax your neck. Gently move your head from side to side.
  • Tighten and release your jaw muscles.
  • Finally, the top of your head. Imagine all the tension in your body has floated out of the top of your head, leaving you relaxed and refreshed.
  • Finish with some more deep breaths. If you are able, stay in this position for a few more minutes of calm and relaxation.

One of my favorite PMR scripts is called “Anesthesia.”  It uses the same concept as the one above, except instead of tensing the muscles, you imagine each part of the body is dipped into a bowl of anesthesia, causing it to fall asleep. It’s so relaxing you just might fall asleep afterward. I once relaxed this way while getting a tooth pulled!

Other techniques include meditation, guided imagery, and acupressure/acupuncture etc.

Check out this post I wrote for the A to Z Blogging Challenge on Progressive Muscle Relaxation.

Planning: Energy Conservation

One thing cancer patients learn quickly is the importance of conserving their energy. This involves scrutinizing your schedule to ensure it isn’t too full.

  1. Plan your week so that you don’t have more obligations than you can handle each day.
  2. Plan your day according to your priorities. What:
    • do you need to accomplish?
    • would you like to accomplish?
    • can wait until another time if you can’t get to everything?
  1. Pace yourself.
    • Think about the big picture.
    • How will a morning appointment affect the rest of your day?
  2. Plan Your Position.
    • Consider where and when you will be able to sit throughout the day.
    • Getting a shower seat can be helpful when just taking a shower wears you out.
    • Some people get a walker, to always have a seat when they need one. Standing in line can be particularly difficult because there is nowhere to sit.
    • For things like vacations and state fairs, nothing beats a scooter. There are scooter rentals available everywhere. They will even deliver and pick up at hotels.

Your Environment

Avoid environmental triggers which lead to shortness of breath.

  • Smoking
  • Air pollutants
  • Allergens
  • extreme temperatures (Humidity, Cold)

A scarf or face mask can be helpful for reducing the impact of these triggers. In Minnesota, the cold winter air was very hard on my husband’s breathing. It sent him into terrible coughing fits. He began to use a face mask like doctors use. This made a big difference.

Many Tools for Many Factors

Learn multiple approaches to managing breathlessness and what learns best for you. You will have a variety of ways for dealing with the various things that contribute to shortness of breath.

Next time…

We will look at exercises that can reduce the impact of breathlessness on your life.

WHAT ARE YOUR THOUGHTS?

I’d love to hear in the comment section, below. I appreciate my readers as well as the writing community. To show that appreciation, I use Comment Luv. Just leave a comment below and your latest post will get a link next to it. Thank you!

ABOUT HEATHER ERICKSON

In 2012 doctors diagnosed my husband, Dan, with stage IV lung cancer. Since then, our family has been learning what it means to face cancer. I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, in spite of their illness. My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com

I also blog at Heather Erickson Author/Writer/Speaker

Footnotes:

Dr. Lynn Reinke, Ph.D., ARNP, FAAN (University of Washington) is a nurse practitioner, recognized nationally and internationally as a dyspnea crisis management expert.

 

 

Originally posted 2018-11-19 07:00:57.


This week I’m taking a break from Facing Cancer with Grace, so I can face cancer with grace. My husband’s health has taken a turn for the worse. I thank you for your prayers and understanding.


Breathlessness A Medical Approach

This is part 2 of our Breathless Series. In Part 1, we looked at some of the reasons for breathlessness in cancer patients. I also shared my husband’s experience with shortness of breath to the point he nearly died. There are both medical and non-medical approaches to alleviate the symptoms of breathlessness. In this post, we will talk about the medical approach.

The Lung Cancer Alliance

In 2017, the Lung Cancer Alliance recently held a webinar called, “Breathing Easier.” It was the first webinar in their Coping Series. This is a series designed to educate and provide practical ways to manage the most common symptoms and side effects experienced by lung cancer patients and survivors. Because Approximately half of all cancer patients complain of breathlessness at some point. (1) The information they shared is valuable to an even wider audience of cancer survivors.

Much of the information in this post comes from the webinar. I appreciate the Lung Cancer Alliance allowing me to share it (originally at Heather Erickson Author/Writer/Speaker). I encourage you to go to their website to learn more ways of coping with lung cancer.

Treat the Cancer

Dr. Lynn Reinke, Ph.D., ARNP, FAAN (University of Washington) is a nurse practitioner, recognized nationally and internationally as a dyspnea crisis management expert. She says that the first key to managing shortness of breath is to treat the lung cancer [or any cancer that has metastasized to the lungs] along with its symptoms.

Our Story

When my husband, Dan, experienced severe shortness of breath, it was because his cancer was out of control. It prompted his doctors to order a new CT scan. The results told us that it was time to change treatments. The following month, there were more scans and his treatment plan changed with each one until they found one that worked. That was when he could breathe again! Until then, several other medications were used to help with his cough and breathlessness.

Medications for Breathlessness

As we learned in the first post in this series, there are many causes of breathlessness. Talk to your provider about what medications are appropriate for you.

Also, learn the correct way to use these medications to maximize the effectiveness.  Because many of these medications are inhaled, the technique you use is very important. When you are being prescribed an inhaled medication, a doctor or nurse will be happy to demonstrate the proper way technique. They can also give you a “spacer.” The Asthma Society of Canada has a great illustration and instructions on their site for using a spacer.

Bronchodilators such as albuterol are fast acting and helpful to use prior to activity that may cause shortness of breath.

Breathlessness
(2)

Long-acting bronchodilators last 12 hours. Some use steroids and some reduce inflammation in the lungs.

Nebulizers are helpful for acute breathlessness. A nebulizer is a portable machine which delivers the medication in the form of a breathable mist.

 

 

Other medications:

Opioids, such as low doses of morphine (10-30 mg) are widely used to manage breathlessness. Even experts don’t fully understand why they work. The anxiety-reducing and cough-relieving effects of diamorphine make it ideal for lung cancer. Even patients with COPD can safely use oral morphine for shortness of breath, The patient starts on a low dose, and which is raised per response and side-effects. This level of morphine is well below the amount that patients are prescribed for pain.

Anti-anxiety medications such as lorazepam. Shortness of breath can trigger anxiety attacks. Anxiety, in turn, causes people to tense up and this further reduces lung capacity. It can become a vicious cycle. Anxiety medications can end this cycle.

Oxygen

Oxygen is only helpful if the blood levels of oxygen are low. You can still experience breathlessness without having a low blood-oxygen level. To see whether oxygen is appropriate for you, doctors will test your oxygen level with an oximeter. That’s the little clamp they place on your finger that has a red light in it. Normal blood oxygen levels are between 75 and 100 mmHg (millimeters of mercury). A level of 60 mmHg or lower indicates the need for supplemental oxygen.

Our Story

People often asked why the doctors didn’t put Dan on oxygen when he was so sick. His numbers were always borderline, but not low enough to merit oxygen therapy. It was counter-intuitive to us since he was struggling to breathe. Yet, these guidelines are in place for a very good reason. Too much oxygen can be dangerous, as well. Levels of over 110 mmHg can damage the cells in your lungs.

Next Post…

Non-medical interventions are often the most effective way to cope with long-term treatment of breathlessness. In the next post, we will look at non-medical approaches to breathlessness, including breathing techniques and exercises. If you haven’t already signed up to receive alerts when our weekly post is up, do that now. If you know someone who is living with cancer, pass this along to them.

WHAT ARE YOUR THOUGHTS?

I’d love to hear in the comment section, below. I appreciate my readers as well as the writing community. To show that appreciation, I use Comment Luv. Just leave a comment below and your latest post will get a link next to it. Thank you!

ABOUT HEATHER ERICKSON

In 2012 doctors diagnosed my husband, Dan, with stage IV lung cancer. Since then, our family has been learning what it means to face cancer. I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, in spite of their illness. My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com

I also blog at Heather Erickson Author/Writer/Speaker

Footnotes:

1 Virtual Medical Center, Breathlessness in Cancer; https://www.myvmc.com/symptoms/breathlessness-in-cancer/

2 By Trainer2a (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

 

 

Originally posted 2018-11-12 07:00:39.


Baby Steps for resilience

Realistic goals are an essential part of becoming resilient on a cancer journey. Unfortunately, too many people have unrealistic goals. This leads to frustration; frustration with others and frustration with themselves. Thankfully, with some time and practice, these habits can be changed.

Baby Steps toward Your Realistic Goals

Realistic goals start by realizing that life is made up of baby steps, more than grand leaps and bounds. If you’ve ever been a runner, you know that a person can sprint at a very high speed for a short distance, but they could never run a marathon at that same speed. They would quickly burn out. It’s all about pacing, to ensure they can go the distance.

Starting is Easy

In the beginning, we start with a lot of drive and energy. Much of it comes from the adrenalin. You get yourself mentally pumped up to reach a certain goal. But, if the goal is one that will be difficult to reach, that initial drive will eventually wear off. So having smaller, more realistic goals that you can reach can help you to utilize that initial energy. Then, once you’ve reached that goal, celebrate your victory and set a new one.

Constancy is Hard

This is especially true when you are facing a cancer battle. Some days, just getting out of bed can be a herculean task. Other days you feel energized and ready to face the world. And, it’s not just physical.  Your emotional well-being plays a huge role in your ability to stay consistent.  Setting realistic goals will help make this easier.

It is also important to be gentle with yourself. Talk to yourself like you would a friend, with compassion and understanding.  Too many people mentally beat themselves up for not reaching some arbitrary level of achievement each day. So often they don’t even have realistic goals, so it’s unfair to pour out that self-criticism.

Strengths Focused Goals

Know what you can do, now, not back before you were a patient or caregiver. Those are 2 different worlds. Also, do the things you have the strength for. If you are physically weak, it might be a day to quietly read to your grandchildren. if you have extra energy, you may want to fix the leaky faucet in the kitchen.

We began a system of “One Thing a Day.” When we look at our calendar, we should only have one big thing to do each day. It might be a doctor’s appointment or going to breakfast with a friend or cleaning the bathroom. Once you’ve achieved that realistic goal, give yourself permission to take the rest of the day off with no guilt attached.

Realistic Goals don’t include Comparisons

The biggest hindrance to this is comparison. You see the things your friends are doing on social media and you wonder why you can only do this one thing each day before wearing out. One of my mottos is, “Comparison is the devil’s favorite weapon.” Don’t let him use it on you by comparing yourself to someone else.  It will only lead to frustration.

How do you ensure that your goals are realistic goals?

WHAT ARE YOUR THOUGHTS?

There is so much more that could be said about this, but I will leave that up to you, my readers. Tell me your thoughts in the comment section, below. I appreciate my readers as well as the writing community. To show that appreciation, I use Comment Luv. Just leave a comment below and your latest post will get a link next to it. Thank you!

facing cancer as a parent

Now Available!!

Facing Cancer as a Parent: Helping Your Children Cope with Your Cancer

ABOUT HEATHER ERICKSON

In 2012 doctors diagnosed my husband, Dan, with stage IV lung cancer. Since then, our family has been learning what it means to face cancer. I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, in spite of their illness. My goal is to help people face cancer with grace.

My books are available at Amazon.com:

The Memory Maker’s Journal 

Facing Cancer as a Friend: How to Support Someone Who Has Cancer

Facing Cancer as a Parent: Helping Your Children Cope with Your Cancer

I also blog at Heather Erickson Author/Writer/Speaker


Shortness of breath and cancer

The most common side effect of lung cancer is dyspnea, better known as shortness of breath. 90% of Lung cancer patients experience this at some point, during, and even long after treatment has ended. In a Lung Cancer Alliance survey, lung cancer survivors of 5 or more years, still rated it as their most problematic issue. It isn’t only lung cancer patients who suffer from breathlessness. Approximately half of all cancer patients complain of breathlessness at some point. (1) Shortness of breath is sometimes called air hunger. Unfortunately, for many cancer patients, it’s a part of their everyday life, negatively impacting their ability to do the things they need and want to do.

Our Story

In the fall of 2015, Dan’s stage IV lung cancer had progressed in his lungs and had metastasized to his brain so it was time to change his treatment.  They put him on a new type of treatment called immunotherapy, specifically, Opdivo. We had big hopes for this new drug which had been having great results in many patients.

Within 3 weeks, Dan developed a cough.  Coughing was a known side effect of Opdivo. It was getting worse by the week. In November, less than two months into the treatment, we went away for a romantic weekend in St. Paul. We went on a tour of the St. Paul Cathedral and visited Landmark Center. We stayed at the Covington Inn, a floating bed and breakfast on a tug-boat sitting on the Mississippi River. Before leaving St. Paul, we walked along Summit Avenue, a historic district lined with well-preserved Victorian homes, including the Governor’s Mansion.

It was a turning point in our lives.

We got home in the afternoon and went to bed exhausted. Dan was in bed for days. It became nearly impossible for him to speak without breaking into a coughing fit. He had just walked over a mile down Summit Avenue, and a week later, could no longer walk across the room without having to sit down. He couldn’t get a deep breath.

“Helpless. Frustrating. Scary.”

Shortness of breath can feel like a tightness in the chest or an inability to take a deep enough breath. In 2015, my husband suffered from severe breathlessness.  I asked Dan to tell me in a few words what this felt like. He said, “Helpless. Frustrating. Scary, because as you continue to lose your breath, you know there’s a limit to what you can lose before you have a big problem. You see your everyday life getting more and more difficult. Just taking a shower is exhausting. Soon, you’re bedridden and hospice is the only thing you have to help. It’s really very sad.”

There are many causes of shortness of breath.

Among the causes of breathlessness in cancer patients (especially with advanced cancer) are:

  • pleural effusion (fluid on the lungs)
  • anemia (insufficient red blood cells to transport oxygen)
  • obstruction of airways due to tumors
  • lymphangitis (thickening of the lymphatics in the lung, sometimes caused by cancer cells)
  • removal of part of all of a lung
  • smoking-related lung issues
  • heart failure or damage
  • pulmonary toxicity caused by chemotherapy and/or radiation
  • fatigue and pain which make taking a deep breath difficult
  • an anxiety cycle which causes panic and a sensation of breathlessness.

Treatment Options

Shortness of breath
Lung function tests

Once your doctor determines the cause of your breathlessness, they will be able to give you some treatment options. The treatment for shortness of breath will depend on the cause of it. For example, if it’s caused by pleural effusion, the fluid around the lungs will need to be drained.

shortness of breath

We began an investigation into the matter with his medical team, including an oncologist and a pulmonologist. He had bloodwork, scans, breathing tests, and a bronchoscopy. We were told that Dan’s cough and shortness of breath were was not a side effect of the immunotherapy, as was previously thought. The treatment wasn’t working, so the cancer had been progressing. He had lymphangitic spread (2). This is a term used to describe the spread of cancer throughout the lungs. Cancer was filling his lungs and he couldn’t breathe.

“Do you have a healthcare directive?”

The doctors began talking about decisions that needed to be made at the end of life. “What about intubation?” “Have you reassessed your healthcare directive?” We had lived with Dan’s terminal cancer for over three years and yet we were surprised by these questions. It was like having cold water thrown on us.  It quickly brought the reality we were facing, into focus.

Along with attempts to ease the discomfort of breathlessness, Dan began one treatment after another. First, a traditional chemotherapy, and then two different targeted therapies, recently released by the FDA, each one after another. Finally, one worked, Tagrisso. It began killing cancer cells and he soon regained his lung function.

Next post…

Treatment options for shortness of breath include medical interventions, environmental changes, breathing techniques, and exercises to improve breathing. Be sure to read my next post to learn more about some solutions to shortness of breath. The link will go live when the post is published.

 

WHAT ARE YOUR THOUGHTS?

I’d love to hear in the comment section, below. I appreciate my readers as well as the writing community. To show that appreciation, I use Comment Luv. Just leave a comment below and your latest post will get a link next to it. Thank you!

ABOUT HEATHER ERICKSON

In 2012 doctors diagnosed my husband, Dan, with stage IV lung cancer. Since then, our family has been learning what it means to face cancer. I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, in spite of their illness. My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com

I also blog at Heather Erickson Author/Writer/Speaker

Footnotes:

1 Virtual Medical Center, Breathlessness in Cancer; https://www.myvmc.com/symptoms/breathlessness-in-cancer/

2 lymphangitic carcinomatosis (LIM-fan-JIH-tik KAR-sih-NOH-muh-TOH-sis) A condition in which cancer cells spread from the original (primary) tumor and invade lymph vessels (thin tubes that carry lymph and white blood cells through the body’s lymph system). The invaded lymph vessels then fill up with cancer cells and become blocked. Although lymphangitic carcinomatosis can occur anywhere in the body, it commonly happens in the lungs. It can happen in many types of cancer but is most common in breast, lung, colon, stomach, pancreatic, and prostate cancer. Also called carcinomatous lymphangitis. (NCI Dictionary of Cancer Terms)

 

Originally posted 2018-11-05 07:00:33.


Joyful

I’m doing double duty this month during the A to Z Blogging Challenge. Here at Facing Cancer with Grace, I will focus on caregiving. I’ll also be doing the challenge at Heather Erickson Author/Writer/Speaker, where I will share ways to increase your creativity. I hope you’ll visit me at both sites. While you’re here, sign up for my email list. Today’s post is J for Joyful Despite Cancer.

How can you feel joyful…

…when a loved one has cancer? When we first learned that Dan had cancer, we were stunned. How could this happen? How could my husband of 3 years, be given a death sentence? I felt devastated, even angry. We went through all those classic stages of grief. I was even disappointed in God. It seemed so unfair. Dan and I had a dream marriage. He had just adopted our 3 daughters. We went on annual mission trips and had our family routines. Why us? Why now? I felt many different emotions. Joyful wasn’t one of them.

In order to stage my husband’s cancer, the doctor ordered a PET scan. While Dan was having the scan, I spent a lot of time in prayer. Then, I decided to call a former pastor of ours. He and his wife moved out of state a year earlier, so we got caught up on what was happening in our lives. He could tell that I was really struggling with Dan’s diagnosis. So, he gave me the best advice that I may have ever gotten. He said,

“Don’t think about what you could lose. Think about what you have.”

Those words changed my outlook and helped me become joyful again, despite Dan’s cancer.

Summer loves it when Dan rubs her feet. Image by Jim Bovine

Our life as a family…

…has always had a beautiful rhythm to it. We have routines and traditions that define us:

  • books that we’ve read as a family
  • praying together
  • going to church together
  • watching a TV series as a family
  • family trips
  • walks/hiking
  • Dan making our coffee every morning and filling the gas tank so that I never need to.
  • get-togethers with Dan’s parents and siblings
  • quiet time in the living room

Those things help make this life joyful. When things are difficult, we hold even tighter to these things, remembering how precious they are. We live in awe of God’s grace. We soak it all in with gratitude.

July 2016

Dan had a scan result that pushed us back into reality. It looked like his cancer was progressing again. I remember being in the car, crying, as I thought of what could lie ahead; all the difficult things that Dan would go through. And, in the end, he would die.

I thought about that, about living without him. Then, I thought about what that would mean for him. He would be in the presence of Jesus. I pondered that for quite a while and it gave me such joy. Dan loves Jesus more than anyone and anything. As much as he loves me and the kids, he loves Jesus even more. To be in His presence would be the most wonderful experience he could have. That gave me the strength to face whatever would come our way.

The following month, for reasons that to this day, baffle Dan’s doctors, his cancer retreated and has stayed at bay ever since. He recently had metastases in his spine, but that too has been healing.

October 2012

When doctors told Dan, four and a half years ago, that he had stage IV lung cancer, we could have stopped living. We could have thrown in the towel, but instead, we chose to live a joyful life in spite of cancer.

If you are facing something that seems insurmountable, don’t give up hope. Instead, think about what you have and trust God with it. Then live your life with joy,

Resources

I’m in the early stages of putting together a resource page for caregivers of cancer patients. I’d love it if you’d check it out and email me any suggestions of resources you’d recommend. While you’re here, sign up for my email list to get a periodic email newsletter to encourage you on your cancer journey.

WHAT ARE YOUR THOUGHTS?

I’d love to hear in the comment section, below. I appreciate my readers as well as the writing community. To show that appreciation, I use Comment Luv. Just leave a comment below and your latest post will get a link next to it. Thank you!

ABOUT HEATHER ERICKSON

In 2012 doctors diagnosed my husband, Dan, with stage IV lung cancer. Since then, our family has been learning what it means to face cancer. I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, in spite of their illness. My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com

I also blog at Heather Erickson Author/Writer/Speaker

 

 

Originally posted 2018-04-11 07:00:08.


The ideal you

I’m doing double duty this month during the A to Z Blogging Challenge. Here at Facing Cancer with Grace, I will focus on caregiving. I’ll also be doing the challenge at Heather Erickson Author/Writer/Speaker, where I will share ways to increase your creativity. I hope you’ll visit me at both sites. While you’re here, sign up for my email list. Today’s post is I for the Ideal You vs. the Real You.

One aspect of caregiver guilt that I want to look at more in-depth, is the idea of the ideal you versus the imperfect, real you. The ideal you taunts the real you whenever you don’t measure up.

Not doing “enough?”

Often we have expectations of ourselves that no one could reasonably meet. These unrealistic expectations set you up for disappointment and frustration. Maybe the ideal you is whispering into your ear that you’re not doing enough for your loved one, or, that your caregiving responsibilities are taking away time from your spouse, children or even friends. You might see the way coworkers or friends are living and compare. Comparison breeds envy or pride. Neither of these is based in reality.

The best thing you can do is to realign your goals with the reality you are living. See where you can reduce your responsibilities, and how you can delegate some of the rest. Lower your standards from ideal to real. Everyone—the patient you care for, family members, and you, must lower your standards a little bit and do the best you can. Aim for a B+ in some areas of your life rather than an across-the-board A+.

When guilt nags, ask yourself what’s triggering it:

  • A rigid “I ought to do this. I ought to do that?”
  • An unrealistic belief about your abilities? Even the ideal you doesn’t have superpowers. Try to get comfortable with that gap between perfection and reality instead of beating yourself up over it.
  • Guilt for spending time away from your loved one. You finally get up the courage to go out and do something for yourself. Rather than enjoying the break, you feel guilty for having a good time while your loved one is ill.

 

Guilt loves impossible standards set by the ideal you.

The real you isn’t perfect—neither is anyone else. No caregiver anticipates every problem that can arise. Tempers flare. Appliances break. Germs sneak in. Visitors show up at the worst time! Checks bounce. Life happens. Because of this, no matter how much you love the person, or how much you feel you “owe” him or her, know that you are the real you—not the ideal you. Set your expectations with that in mind and everyone will be a lot happier.

ideal vs real

Musts and oughts

“I ought to visit more often. Twice a week isn’t enough.” This kind of thinking is a little more tricky. Sometimes, it is legitimate. More often, the ideal you just piles on the guilt without any merit. When you think in terms of musts and oughts, consider things as they really are. Are there friends and family who can pitch in and reduce your load?

You weren’t meant to do this alone.

It’s interesting that guilt often comes to call as soon as a caregiver’s load is lightened by getting help. The ideal you whispers that it’s weak to ask for or find assistance. Ask for help.

There isn’t enough of me to go around

So, you were living your life. Maybe you had a job, family obligations, maybe church activities, things you volunteered for. Then, bang! A loved one gets cancer and you must step up to the plate. You don’t feel equipped, but you love them so you’ll do it. At the same time, you try to keep up the other commitments you have in life. The ideal you spurs you on to perfection and the real you falls short every time. You feel exhausted. Anyone who’s been a mom has likely experienced this strain of guilt at some point. Whether a mom has one child or eight, she has enough love to go around. She does have to make changes in the way she runs her household, though.

Revisit and reinvent the “Ideal You”:

The real you will have to make the best choices based on the resources and knowledge you have at the time. You will be a more effective caregiver when you care for yourself first. Loved ones neither want nor expect selfless servants, worn and burned out because they never took a break or asked for help. When you care for yourself, you increase and improve your ability to be the caregiver your loved one needs. The true ideal you is someone resourceful; Someone who gives others the opportunity they’ve been looking for to help.

The true ideal you knows it’s wise to lighten your mental load by talking with a friend, a therapist, or a peer group. It’s normal to feel overwhelmed. Asking for help to run errands, make meals, and take care of chores around the house can close the gap between the real you and the ideal you. One you feel the peace that comes from delegating, you will find that the real you and the ideal you become one in the same.

Resources

I’m in the early stages of putting together a resource page for caregivers of cancer patients. I’d love it if you’d check it out and email me any suggestions of resources you’d recommend. While you’re here, sign up for my email list to get a periodic email newsletter to encourage you on your cancer journey.

WHAT ARE YOUR THOUGHTS?

I’d love to hear in the comment section, below. I appreciate my readers as well as the writing community. To show that appreciation, I use Comment Luv. Just leave a comment below and your latest post will get a link next to it. Thank you!

ABOUT HEATHER ERICKSON

In 2012 doctors diagnosed my husband, Dan, with stage IV lung cancer. Since then, our family has been learning what it means to face cancer. I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, in spite of their illness. My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com

I also blog at Heather Erickson Author/Writer/Speaker

Originally posted 2018-04-10 07:00:48.

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